1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wonspark@skku.edu 2Department of Pediatrics, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. 3Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Seoul, Korea. 4Department of Pediatrics, Dong-A University College of Medicine, Korea. 5Department of Pediatrics, Inje University College of Medicine, Busan Paik Hospital, Korea.

극소 저체중 출생아에서 조기 패혈증의 원인균과 예후인자

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Abstract

PURPOSEThis study was conducted to determine the incidence, causative pathogens, risk factors and mortality for early onset sepsis in the first three days in very low birth weight infants.METHODSThe medical records of 1,124 very low birth weight infants admitted to the neonatal intensive care unit of Samsung Medical Center between November 1994 and December 2008 were retrospectively reviewed. The incidence, causative pathogens, risk factors, and mortality for early onset sepsis in the first 3 days of life in very low birth weight infants were evaluated.RESULTSEarly onset sepsis, as confirmed by positive blood cultures, was present in 17 of 1,124 infants (1.5%).
Sixty-four percent of the isolated pathogens were gram-positive bacteria and 35% of the isolated pathogens were gram-negative bacteria. The dominant pathogens of early onset sepsis included Staphylococcus aureus (23.5%), Esherichia coli (23.5%), and Enterococcus (17.6%). Vaginal delivery (adjusted odds ratio [OR], 3.7; 95% confidence interval [CI], 1.3-10.3; P=0.01) was associated with early onset sepsis. The overall mortality (adjusted hazard ratio, 3.0; 95% CI, 1.4-6.5; adjusted P=0.0039) and mortality within 72 hours of life (adjusted hazard ratio, 6.5; 95% CI, 2.2-18.9; adjusted P=0.0005) of infants with early onset sepsis were higher than that of uninfected infants.CONCLUSIONEarly onset sepsis remains an uncommon, but potentially lethal problem among very low birth weight infants. Knowledge of the likely causative organisms and risk factors for early onset sepsis can aid in instituting prompt and appropriate therapy, in order to minimize mortality.